Please stop wiping those instruments with alcohol — ASN Events
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  3. Please stop wiping those instruments with alcohol

Please stop wiping those instruments with alcohol (#216)

Dayane M Costa 1 2 , Lillian KO Lopes 1 2 , Honghua Hu 1 , Anaclara FV Tipple 2 , Karen Vickery 1
  1. Macquarie University, Macquarie Park, NSW, Australia
  2. Faculty of Nursing, Federal University of Goias, Goiania , Goais, Brazil

In Brazil, some healthcare workers (HCW) believe that wiping surgical instruments with alcohol soaked swabs, post-use, will decrease biological soil and bacterial contamination of instruments, particularly if reprocessing is delayed.  However, this practice is not recommended in disinfection and sterilization guidelines1-3. The aim of this study is to determine the effect of this practice on amount of soil and bacterial numbers on surgical instruments prior to processing.

Methods

Forty artery forceps were contaminated by soaking in tryptic soya broth containing (TSB) 108 CFU/ml of S. aureus or P. aeruginosa for 5 minutes. The forceps were allowed to air dry for 4 hours and subjected to various treatments with alcohol (80% v/v): none (control: 4 and 24 hours drying), wiping multiple instruments with one alcohol soaked swab, wiping a single instrument/soaked swab and spraying with alcohol. The instruments were left at room temperature for 20 hours. Bacterial numbers were determined following sonication in saline and standard plate culture. Residual soil was stained with crystal violet and quantified by spectrophotometry. The experiment was repeated twice.

Results

Bacterial contamination: Spraying instruments with alcohol decreased bacterial contamination (S. aureus 3 log reduction; P. aeruginosa 5 log reduction) compared to the controls. Reusing the same alcohol wipe for multiple forceps or changing the wipe between forceps had contamination to levels similar to the controls for S. aureus, but there was a slight reduction (1 to 2 log in both groups) for P. aeruginosa. 

Residual soil: neither wiping with alcohol soaked swabs nor spraying with alcohol decreased residual soil.

Discussion

Although spraying the instruments with alcohol decreased bacterial growth, probably due to better penetration of alcohol, residual soil remained high and similar to the control instruments. The practice of wiping instruments with the same alcohol soaked swabs for multiple instruments has two detrimental effects 1) possibility transfer bacteria from one instrument to another 2) alcohol acts as a fixative, increasing the difficulty in removing residual soil. Additional research and education is required in order to convince HCW to cease this practice.

  1. Rutala WA, Weber DJ. The Healthcare Infection Control Practices Advisory Committee – HICPAC. Guideline for disinfection and sterilization in healthcare facilities, 2008. 158p.
  2. Associação Brasileira de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização - SOBECC. Práticas recomendadas da SOBECC. 6.ed. Revisada e atualizada.São Paulo: SOBECC, 2013. 369p.
  3. Australian Guidelines for the Prevention and Control of Infection in Healthcare. 2010. 279p. Available in: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cd33_infection_control_healthcare_140616.pdf
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